Francis Ayson
Francis Ayson is an analyst with the San Diego office of Milliman. He joined the firm in 2017, and has been working in health reimbursement and pharmacy since 2006.
Experience
Francis has previously worked for a major pharmacy benefit manager (PBM) and health insurance organization. He has experience with underwriting, data analysis and reporting, configuration, performance guarantee tracking, and Part D compliance. In addition, Francis held positions in internal audit, contracts, and configuration services.
Francis’ specialties are in pharmacy claims auditing, rebate audits, performance guarantees, and Part D compliance. He worked with configuration services for Part D compliance and designed a process for Part D compliance notification and issue reporting. He has supported a wide range of clients, including Medicare Part D plans, state Medicaid plans, health plans, self-insured employer groups, and third-party administrators.
Francis’ experience includes:
- Account management
- Benefit plan design
- Contracting
- Copay programs and financial assistance
- Data analysis and reporting
- Insurance and health reimbursement
- Medicare Part D compliance
- Medicare Part D Employer Group Waiver Plans (EGWP)
- Medicare Part D Retiree Drug Subsidy (RDS)
- Medicare Part D star ratings
- Performance guarantees
- Pharmacy benefit manager audits
- Pharmacy claims processing
- Proposals
- Rebate audits
PBM Best Practices Series: Pharmacy benefit claims auditing (September 2023)
- BS, Biology, University of Texas, Dallas
- MS, Healthcare Management, University of Texas, Dallas